Kidney stones on the increase - but more patients will now be treated locally

INCREASING numbers of Islanders are being diagnosed with kidney stones because they are not drinking enough water and are obese, according to a Hospital consultant.

Kidney stones on the increase - but more patients will now be treated locally

But a new £15,000 flexible ureteroscope, which has been funded by the Jersey Friends of the Urology Foundation and can diagnose the stones and break them up using a laser, means that more Islanders who previously would have needed treatment in the UK for the condition can now be treated locally.

  • Kidney stones are stone-like lumps that can develop in one or both of the kidneys.

  • The medical name for them is nephrolithiasis. If the stones cause severe pain, this is known as renal colic.

  • Small stones may be passed out painlessly in the urine and may even go undetected. However, it is fairly common for a stone to block part of the urinary system, such as the ureter (the tube connecting the kidney to the bladder) or the urethra (the tube urine passes through out of the body). If this happens, it can cause severe pain in the abdomen or groin and sometimes causes a urinary tract infection.

  • Kidney stones are formed as the waste products in the blood can occasionally form crystals that collect inside the kidneys. Over time, the crystals may build up to form a hard stone-like lump.

  • This is more likely to happen if you don't drink enough fluids, are taking some types of medication, or have a medical condition that raises the levels of certain substances in your urine.

  • After a kidney stone has formed, your body will try to pass it out of the body in urine. This means it will often travel through the urinary system (the kidneys, kidney tubes and bladder).

  • Kidney stones are quite common and usually affect people aged 30 to 60 years. They affect men more than women.

  • It is estimated that renal colic affects about 10 to 20% of men and 3 to 5% of women.

  • Most kidney stones are small enough to be passed in your urine, and it may be possible to treat the symptoms at home with medication. Larger stones may need to be broken up with X-rays or ultrasound in hospital, or you may need to have them surgically removed.

  • It is estimated that up to half of all people who have had kidney stones will experience them again within the following five years.

Ben Hughes, consultant urologist at the Hospital, today urged Islanders to drink two litres of water a day and to loose weight if they are obese to reduce the risk of developing kidney stones.

If left untreated kidney stones can lead to infection which can result in kidney failure.

Mr Hughes said the Hospital had previously estimated that 80 Islanders annually would require treatment for kidney stones.

But last year the Hospital treated 130 patients for the condition.

It is estimated that 150 Islanders will be treated this year. To date in 2015 20 Islanders have undergone treatment.

Mr Hughes said: 'The incidence of stones is on the increase. Mostly the increase is due to the rise in levels of obesity and type two diabetes.

'Kidney stones can often happen due to people not drinking enough water.'

He said kidney stones could be 'exquisitely painful' and generally affect people aged between 20 and 50, although he said he had treated a 15-year-old with the condition.

The scope can also be used to take biopsies and cauterise cancer cells from within the kidney. So far it has been used to perform 15 such operations involving five Islanders.

Geoffrey Grime, from the Jersey Friends of the Urology Foundation, said that between 2006 and 2013 the organisation had raised £130,000 for the UK-based charity through a series of dinner-dance events.

He added: 'I've always said if I was involved in an English charity it would be nice to get something tangible for the Island. This is a great piece of equipment as it saves a lot of people having to go to England.'

MEANWHILE, on Monday, it was revealed that the number of Islanders who require kidney dialysis is almost eight times higher now than it was two decades ago.

An ageing population along with conditions such as diabetes and high blood pressure mean that more Islanders are suffering from kidney disease, an illness which can lead to kidney failure.

  • Your kidneys are vital organs that filter your blood up to 30 times a day. They keep what is needed and get rid of what is not needed through urine.

  • Each of your two kidneys is about the size and weight of a mobile phone. Placed end to end, the filters in one kidney would stretch about five miles.

  • Your kidneys help keep your bones healthy by activating vitamin D.

  • Kidneys have some control over your red blood cells – if your kidneys are not getting enough oxygen they send a signal to your body to make more red blood cells and prevent you from becoming anaemic (deficiency of red blood cells). Your kidneys are responsible for keeping the components of your blood in balance.

  • Your kidneys use one quarter of your body’s energy. They work 24-hours-a-day, seven-days-a-week for the whole of your life. They have a higher blood flow rate than your heart, brain or liver.

  • Kidneys keep on working until they have lost up to 90% of their function. They are the unsung heroes of our bodies and don’t stop working until they really can’t cope.

  • Your body can work with just one kidney so a kidney can be donated to someone who needs it with no detriment to the donor.

Source: NHS

A senior sister on the Hospital's renal unit has told the JEP that the number of Islanders with kidney disease has soared in recent years and that globally numbers are expected to rise by another 17 per cent in the next decade.

She added that smoking, obesity and a high-salt intake from eating processed foods as well as not drinking enough water are all triggers to increasing a person's chance of getting the illness.

In 1996 just five Islanders received dialysis - which people need to undergo if their kidneys fail - in the Hospital's renal unit. Today 37 people receive the life-saving treatment.

Meanwhile, 60 patients attend the unit's clinics for support in monitoring and treating their condition to try and prevent it from progressing to kidney failure.

Lindy Taylor, senior sister, said the renal unit is busier since she joined 19 years ago and that this reflected trends in the UK and worldwide.

She added: 'Ten per cent of the population will have some kind of kidney damage worldwide. It is predicted to rise by 17 per cent in the next decade.

'We have an ageing population. The older people get the more likely they are to have kidney damage. Diabetes and high blood pressure are leading causes of kidney disease.'

When a person's kidneys lose 85 to 90 per cent of their functionality they require dialysis. This removes waste, salt and excess water from the body. It also helps to control blood pressure and maintain a safe level of chemicals such as potassium and sodium in the blood.

Thirty-four Islanders receive haemodialysis, where blood is pumped through a machine which cleans it before it is returned to the body. This involves three sessions a week with each session lasting up to four hours.

Meanwhile, three Islanders undergo peritoneal dialysis, where a special fluid is pumped into a plastic tube that has been inserted into the abdominal cavity. This form of dialysis can be done either manually or by machine at home, thereby avoiding the need to go to Hospital.

Mrs Taylor said: 'Peritoneal dialysis gives people more choice. We only had one patient for a long time but we've got two more this year.'

A Haemodialyysis unit

She added that in the future it is hoped that the Health Department may be able to carry out haemodialysis in Islanders' homes as it looks to offer more care in the community.

But Mrs Taylor said that simple measures such as drinking enough water to flush out the kidneys and a healthy diet can all lower the chance of developing the illness.

She said: 'It's about promoting a lifestyle which helps reduce the early risk and to prevent the progression of kidney disease.

'We would encourage people to stop smoking and to lose weight. It's all about non-processed foods. Processed foods have high salt in them.'

  • You are more likely to need a transplant than become a donor

  • A donor can donate a heart, lungs, two kidneys, pancreas, liver and small bowel and can restore the sight of two people by donating their corneas

  • Donors can also give bone and tissue such as skin, heart valves and tendons. Skin grafts have helped people with severe burns and bone is used in orthopaedic surgery

  • Traditionally organ donors have come from two groups: road accident and brain haemorrhage patients. Improved road safety and medical intervention mean that fewer people in both groups are dying

  • The age of people who have donated organs after their death has changed in the past decade with more aged over 50 and fewer younger donors. Older donors are less likely to be able to donate as many of their organs as younger people, as some organs may become less suitable for transplantations as people age. But organs from people in their 70s and 80s can be transplanted successfully

  • The number of people needing a transplant is expected to rise steeply over the next decade due to an ageing population, an increase in kidney failure and scientific advances resulting in more people being suitable for a transplant

  • Surgical techniques, such as splitting livers, have meant that a donor can help more patients than ever before[/breakout]

AMAZING advances in medical science mean we can expect to live longer than ever before. Diseases which once led to large numbers of deaths have been all-but eradicated with sophisticated drugs and a better understanding of prevention.

And yet these huge steps forward seem to have gone hand in hand with an increasing appetite for salt, fat, sloth and a multitude of other vices which have a nasty habit of shortening life expectancy.

Today, we learn that the number of people needing kidney dialysis has soared eight-fold in the past 20 years, the increase driven by unhealthy lifestyles and an ageing population.

The impact of preventable illness hits the headlines in this newspaper with alarming regularity – and yet still people smoke, drink and eat to excess.

Yet more regulation and restrictions of personal liberties should be a last resort, but Health will be left with nowhere else to turn if people refuse to help themselves.

Tens of millions of pounds have to be cut from public expenditure over the next four years if Jersey is to avoid a structural deficit.

If Islanders want to put their weight behind the drive for efficiencies, a more responsible attitude to personal health would be a good place to start.

Anna-Marie Barlow on a dialysis machine

ANNA-MARIE Barlow has a suitcase packed ready in the hope that one day soon she will get a phone call to say that a suitable donor has been found.

The mother-of-two has been battling chronic kidney disease for 14 years, a condition which has put her life on hold and caused her family immense worry.

Every day Anna-Marie says she thinks about getting a new kidney that would enable her to live life to the full with her children Ryan and Kelsey Videgrain. But in the meantime, due to the severity of her condition, Anna-Marie spends a lot of her time at the Hospital where she has to undergo dialysis to clean her blood of toxins.

She said: 'The children are very low. They talk about my condition a lot of the time. My parents also worry. They are very concerned. 'It has put my life on hold and stopped me from doing things.'

Anna-Marie, the secretary of the Jersey Kidney Patients Association, said: 'I think about it every day. I've got two children. I do worry. At the moment I can't do anything. 'I'm bound in what I can do. I can go away for day trips but I can't go on a nice holiday with the kids as I've got to make sure I can access the right care if I need to.'

Anna-Marie was just 27 and pregnant with Ryan, now a bank worker, when medics told her the devastating news that she had chronic kidney failure. The diagnosis left Anna-Marie, who was working in customer care at the time, reeling.

She said: 'I was gutted. It was a lot to take in. I was really upset and in shock.'

Doctors predicted that within a year she would need dialysis.

But she managed without it for five years until her health deteriorated so badly that she had no other choice.

And going from being a young and fit young woman to one whose life was dominated by medical appointments and dialysis came as a 'great shock', says Anna-Marie.

She said she had to adapt to manage her illness, including keeping a close eye on what she eats as certain foods, such as those that contain a lot of potassium, can play havoc with her condition.

She said: 'At first I had lines in my neck for the dialysis. That stopped me from swimming as I went to a public pool and didn't want the lines to become infected.

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